Miyuki Matsubara

Fine needle aspiration cytology of primary epithelioid sarcoma. A report of 2 cases.

BACKGROUND Epithelioid sarcoma is a rare soft part tumor, the cytologic features of which have not been fully elucidated to date. We describe the cytologic features in 2 cases of primary epithelioid sarcoma with samples obtained by fine needle aspiration (FNA). CASES Case 1 was a 50-year-old male who complained of a small mass in his left palm. Case 2 was a 56-year-old female who presented with a mass on the medial aspect of her right forearm. Preoperative FNA smears in both cases showed loose, aggregated and isolated tumor cells that were round to polygonal, with eccentrically located nuclei, against a background of inflammation and necrosis. The tumor cells showed moderate atypia, irregularity in size and many mitoses. In case 1 a presumptive diagnosis of epithelioid sarcoma was made by FNA cytology, while in case 2, FNA cytology revealed a high grade sarcoma with abundant matrix mimicking osteoids, difficult to differentiate from an extraskeletal osteosarcoma. CONCLUSION Epithelioid sarcoma may be difficult to differentiate from an extraskeletal osteosarcoma in cases with abundant hyalinized collagen on FNA cytology.

Fine needle aspiration cytology for soft tissue tumours of the hand.

The purpose of this study was to evaluate the usefulness of fine needle aspiration cytology for the preoperative diagnosis of soft tissue tumours of the hand. Fine needle aspiration cytology was performed on 93 soft tissue tumours of the hand which were classified as malignant, benign or unclassified based on cytological findings. We also attempted to make specific diagnosis by cytology. The cytological diagnosis was then compared with the postoperative histopathological diagnosis. The cytological differentiation between benign and malignant tumours showed neither false-positive nor false-negative results. Of the 47 lesions with sufficient material for cytology and that were postoperatively diagnosed histologically, 35 (including one recurrent lesion) were correctly diagnosed by fine needle aspiration cytology. No complications were encountered. Fine needle aspiration cytology has a high degree of diagnostic accuracy and safety for soft tissue tumours of the hand.

Pleomorphic lobular carcinoma of the breast: a comparison of cytopathological features with other lobular carcinoma variants

Pleomorphic lobular carcinoma (PLC) is a subtype of breast cancer with unique morphological features, but it remains controversial whether PLC should be considered an independent disease entity. The aim of this study was to illustrate cytopathological characteristics of PLC in comparison with other lobular carcinoma variants.

Fine needle aspiration cytology of the papillary thyroid carcinoma with a solid component: A cytological and clinical correlation

Solid variant of papillary thyroid carcinoma is a rare subtype of papillary thyroid carcinoma (PTC) containing a solid component (SC), and thus its cytological and clinicopathological features remain elusive. We examined fine needle aspiration (FNA) cytological features of PTC with variable degrees of SC (20‐80% of the tumor)(PTCSC) in comparison to well‐differentiated PTC (WPTC).

Mucinous carcinoma of the breast: a comparative study on cytohistological findings associated with neuroendocrine differentiation.

Mucinous carcinoma (MCA) may show neuroendocrine differentiation (ND), but the cytological features characteristic of ND remains elusive. We compared fine needle aspiration (FNA) findings of MCA between cases with high and low degrees of ND.

Breast carcinoma with osteoclast-like giant cells: A cytological-pathological correlation with a literature review

Breast carcinoma with osteoclast-like giant cells (OGCs) is a rare disease characterized by the infiltration of OGCs in the tumor; however, cytological aspects of this tumor type remain elusive. We examined the cytological features in fine needle aspiration (FNA) biopsy smears obtained from 5 patients who were histologically diagnosed with breast carcinoma with OGCs. We compared FNA and clinicopathological findings with results from the published literature. Histological assessment of the resected samples showed that all tumors exhibited a histological grade 1 phenotype with a predominant cribriform architecture. Four patients were estrogen receptor positive, and 1 patient showed a triple negative phenotype. All patients survived without tumor recurrence. In the FNA smears, tumor cells were arranged in loosely cohesive clusters, characterized by varying degrees of OGCs infiltration and rare formation of solid tumor nests. Occasionally, 2- or 3-dimensional clusters of tumor cells were found, accompanied by OGCs at the peripheral regions. In all patients, tumor cells were small without severe nuclear atypia. None of the patients showed significant background necrosis. In summary, cytological features of breast carcinoma with OGCs are characterized by loose aggregates of low grade tumor cells, the presence of OGCs, and the absence of necrosis, all of which were consistent with features reported previously. This peculiar form of breast tumors should be included in the differential diagnosis, when physicians encounter FNA findings including low grade ductal carcinoma with the admixture of multinucleated giant cells or OGCs.

A rare case of myxoid liposarcoma of the adult foot diagnosed using fine needle aspiration cytology (FNAC)

License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Pathology and Laboratory Medicine International 2015:7 1–5 Pathology and Laboratory Medicine International Dovepress

Atypical pneumocytes appearing in interstitial pneumonia

目的:腺癌との誤判定を回避するため, 間質性肺炎 (IP) 症例の細胞診検体における細胞像の特徴の解明を目的とした.方法:気管支擦過, 気管支洗浄液, および気管支肺胞洗浄液に異型腺系細胞が出現し, 臨床病理学的にIPの像を呈した10例を対象に, 同時に施行した生検と比較した.成績:共通した細胞像は, 炎症細胞背景・明瞭な核小体・増量を伴わない粗雑なクロマチン・厚みがあり辺縁明瞭化した細胞質あるいは空胞状の細胞質である. これらが単独および数～10数個で小集塊を形成していた. さらに, 最も特徴的な所見はcollagen globuleとMallory bodyの出現であった.結論:IPでは, 気管支鏡検査や手術により急性増悪を招く可能性のある症例が存在する. このため, collagen globuleやMallory bodyが認められた場合, 腺系細胞の異型性が強くともIPの可能性を考慮に入れ, 慎重に報告することが重要である.

Cytological evaluation of atypical lymphocytes in bronchoalveolar lavage fluid of hypersensitivity pneumonitis.

In hypersensitivity pneumonitis (HP), bronchoalveolar lavage (BAL) sometime show atypical lymphocytes (AT). We compared lymphocytes from (5 patients) with BAL flui from small lymphocytic lymphoma and leukemia (LL from 6 patients). In a Giemsa-stained specimen, 500 lymphocytes per case were categorized as N (normal), A (smaller than a neutrophil, atypical nuclear shape), AS (A with abnormal chromatin), and AL (larger than a neutrophil, with atypia), then calculated the ratio of each category. AT accounted for 14 to 22%(A + AS, AL= 0%) in HP, but LL showed a high A+AS ratio (>51.7%) with AL (>0.2%). Thus, calculating the ratio of small AT is important to avoid misinterpretation of BAL samples when AT is observed.In hypersensitivity pneumonitis (HP), bronchoalveolar lavage (BAL) sometime show atypical lymphocytes (AT). We compared lymphocytes from (5 patients) with BAL flui from small lymphocytic lymphoma and leukemia (LL from 6 patients). In a Giemsa-stained specimen, 500 lymphocytes per case were categorized as N (normal), A (smaller than a neutrophil, atypical nuclear shape), AS (A with abnormal chromatin), and AL (larger than a neutrophil, with atypia), then calculated the ratio of each category. AT accounted for 14 to 22%(A + AS, AL= 0%) in HP, but LL showed a high A+AS ratio (>51.7%) with AL (>0.2%). Thus, calculating the ratio of small AT is important to avoid misinterpretation of BAL samples when AT is observed.

A case of recurrent epithelioid sarcoma suggested by aspiration cytology.

Epithelioid sarcomaは比較的まれな軟部腫瘍で若年成人の前腕, 手掌, 指に好発する.この腫瘍は良性, 悪性の鑑別がしばしば問題となるので, 細胞診に携わる者にとって重要である。今回われわれは穿刺吸引細胞診で再発を推定診断しえたEpithelioid sarcomaの1症例を経験したので報告する。患者は44歳女性で, 右手掌部の腫瘤を主訴として当院に入院した.細胞所見では, 大型類円形ないし多稜形の細胞が主として粗な結合性の小集塊としてみられ, 線維芽細胞様紡錘形細胞も散見された.組織所見では, 腫瘍細胞は結節性に増殖し, 中心壊死傾向がみられた。免疫細胞化学的にkeratin, EMA, TPA, CEA, vimentin, actinが陽性, 電顕的にintermediate filament, desmosome様接着装置が証明された.